Monday, April 22, 2019

Senate hearing examines 'devastating' nursing home abuse

When
Maya Fischer answered, a nurse from the nursing home where her mother
had been staying for more than a decade was on the other end of the
line. In her Minnesota home, Fischer braced herself for difficult news.

"When you receive a phone call from the nursing home, your first thought is that ... my mother has passed," Fischer said.

The news was indeed troubling, but it was not what she expected.

"I
was not at all prepared for the call that I received. ... The call that
my mother had been a victim of a sexual assault in her nursing home,"
Fischer said. "For me and my family, it's been devastating."

Fischer testified in front of lawmakers in the nation's capital on Wednesday. The US Senate Committee on Finance held a hearing
to discuss reports of abuse and neglect in some nursing homes
nationwide and what can be done to protect those of all ages at risk of
abuse.

"My final memories of my
mother's life now include watching her bang uncontrollably on her
private parts for days after the rape, with tears rolling down her eyes,
apparently trying to tell me what had been done to her but unable to
speak due to her disease," Fischer said in the hearing, referring to her
mother's Alzheimer's disease.

Along
with Fischer, Iowa resident Patricia Blank testified about how she is
the daughter of a nursing home neglect victim, Virginia Olthoff. In a
news release on Tuesday, Iowa Sen. Chuck Grassley's office noted
how the nursing home where Blank's mother resided and died "received
the highest possible ranking from the Centers for Medicare and Medicaid
Services (CMS) for quality of resident care, though it had been fined
for physical and verbal abuse a year before Olthoff's death."

"How
a place with the highest possible rating could yield such a tragic
incident is just outrageous," he said in the news release. "Things need
to change, both for the standards at care facilities and for how CMS
rates them. When American families consider where their loved ones can
get the care they need, they should be able to rely on CMS information.
That's clearly not the case right now."

After the hearing, Grassley said in a statement that Fischer's and Blank's stories were "troubling."

"Today
I heard troubling accounts, which lead me to believe continued
oversight is needed in this area. There are two government watchdog
agencies currently working on reports for Congress. One is the Inspector
General of Health and Human Services and the other is the Government
Accountability Office. I plan to convene another hearing on this topic
after these agencies release their reports. I also intend to submit
follow-up questions to each of the witnesses as we work toward reforms,"
he said.

CMS also issued new guidance
Tuesday that "clarifies what information is needed to identify
immediate jeopardy cases across all healthcare provider types, which we
believe will result in quickly identifying and ultimately preventing
these situations," such as abuse or neglect cases.

"Every nursing home serving Medicare and
Medicaid beneficiaries is required to keep its residents safe and
provide high quality care. We have focused on strengthening requirements
for nursing homes, working with states to enforce statutory and
regulatory requirements, increasing transparency of nursing home
performance, and promoting improved health outcomes for nursing home
residents," Dr. Kate Goodrich, director of the Center for Clinical
Standards and Quality at the Centers for Medicare & Medicaid
Services, said in a statement Tuesday.

At
Wednesday's hearing, lawmakers pressed Goodrich on what has been done
and what more could be done to ensure quality at facilities.

There
were several factors mentioned about why a nursing home might fall
behind certain quality standards, including being unable to retain
qualified staff and conduct comprehensive background checks on staff.

"We
do have expectations for nursing facilities for having the appropriate
staffing for their patient population, and we survey for that on a
regular basis," Goodrich said in the hearing.

At
the hearing, New Jersey Sen. Bob Menendez said in response, "I think
there's a gulf between the expectations and the reality in several of
these instances and we look forward to working with you to bridge the
gulf."

Among nursing homes, an exclusive CNN investigation in 2017
found that the federal government has cited more than 1,000 for
mishandling or failing to prevent alleged cases of sex abuse, including
rape and assault, at their facilities between 2013 and 2016 -- before revisions were made in November 2016
relating to how CMS surveys and inspects long-term care facilities.
Fischer's mother's case was one of several in CNN's 2017 investigation.
Her mother has since died.

"My goal
by attending the hearing is simply to be my mom's voice and to put a
face with her name. I don't want her to go down as being just another
horrible statistic," Fischer said. "Stronger legislation needs to be
enacted to protect the elderly. These are some of the most vulnerable
people in our society, and I don't think that we're doing enough to
ensure their safety."

Anyone -- a
nurse, family member or resident -- can report nursing home abuse or
neglect to CMS through state groups or a state's long-term care
ombudsman program, whose information is provided on the Medicare website.

State
health investigators examine all types of abuse reported at nursing
homes and assisted living facilities. In the case of nursing homes,
state officials typically conduct these investigations on behalf of the
Centers for Medicare & Medicaid Services, which regulates the more
than 15,000 facilities that receive government reimbursements that pay
for many residents' care.

Additionally, states conduct standard survey inspections
of nursing homes that are unannounced and can come at any time. Both
state health agencies and the federal government use the information
from routine surveys to rate facilities.

If
abuse or neglect is found in a nursing home, penalties are enforced,
ranging from monetary penalties to termination from the Medicare and
Medicaid program.

The
American Health Care Association represents nursing centers, assisted
living communities and centers and homes for individuals with
disabilities.

Dr. David Gifford,
senior vice president of quality and regulatory affairs at the
association, who testified at the hearing, said in a statement after the
hearing that the group "remains committed to reducing any future cases
of abuse and neglect."

"AHCA
stands ready to work with Congress, members of the Senate Finance
Committee, CMS, and other providers to keep residents safe and continue
improving the quality of care provided. There are robust regulatory
requirements and penalties already in place to ensure patients are
protected and corrective measures are implemented after a case of abuse
or neglect occurs. But we can -- and must -- do more," Gifford said in
the statement.

"We should expand
federal programs that attract health care workers to the nursing home
profession. We should strengthen federal regulations around reporting
and sharing of information about employees who have engaged in abuse
through the creation of a national background check registry. And we
should make resident and family satisfaction ratings of nursing homes
publicly available."

In a response at that time, Mark Parkinson, president and CEO of the American Health Care Association, said in a statement
that long-term care providers have made improvements in quality of
care, such as by reducing rehospitalization rates and increasing
staffing.

"Instead of praise for this progress, we have been subjected to additional scrutiny and criticism," Parkinson said.

"The
reality is that nursing homes are a convenient political punching bag.
Over the years, Congress has turned to us to pay for everything from
student loan debt relief to Medicare physician payments," he said. "At a
time when Congress faces public criticism for its failure to work
together and accomplish shared goals, this hearing seems like a
misguided effort to find more ways to regulate an already overburdened
sector. Long term care is one of the most regulated industries in the
country, yet we've shown some of the most dramatic improvement on both
self-reported and government quality measures."

'I find it hard to believe that the time he was caught was the first time'

George
Kpingbah, the 76-year-old nursing assistant accused of assaulting
Fischer's mother, Sonja Fischer, had a history of sexual assault
allegations.

Personnel records obtained by
prosecutors during the investigation into Sonja Fischer's case and
reviewed by CNN showed that Kpingbah was suspended three times as
officials at Walker Methodist Health Center in Minneapolis investigated
accusations of sexual abuse at the facility, including at least two in
which he was the main suspect.

The
earliest complaint was in 2008, when police investigated allegations
that he had engaged in sexual intercourse with a 65-year-old with
multiple sclerosis. In another case, an 83-year-old blind and deaf woman
who lived on the same wing as Maya Fischer's mother said she was raped
multiple times -- always at midnight.

Police
investigated her report just seven months before Fischer's mother was
assaulted. Though the woman could not identify her assailant, Kpingbah
was suspended, along with several other male staffers who were on duty
during the nights of the alleged assaults.

None
of these allegations was found to be substantiated by the facility or
the state. For years, Walker Methodist kept Kpingbah on the overnight
shift -- until one early morning in December 2014, when someone caught
him in the act.

It was 4:30 a.m.
December 18, 2014, when a fellow caregiver saw Kpingbah in 83-year-old
Sonja Fischer's room at Walker Methodist. The witness noticed the aide
thrusting back and forth, which is when she said she knew that a sexual
assault was occurring.

Kpingbah
ultimately pleaded guilty to third-degree criminal sexual conduct with a
mentally impaired or helpless victim and was sentenced to eight years
in prison.

In a court statement in
2015, Maya Fischer said that her mother, who had Alzheimer's disease,
was "unable to speak" and "unable to fight back" against her assailant.

Fischer
detailed her mother's story, recounting how she had fled Indonesia with
her family to escape the rape and killing of young girls by Japanese
soldiers, only to fall victim decades later to a man whose job was to
care for her.

Sonja Fischer in earlier days.

"I
find it hard to believe that the time he was caught was the first time
he assaulted her, and that will always haunt me," Fischer said Monday.

Abuse
cases typically get reported to state departments of health, and
Fischer hopes nursing homes and state agencies will be more transparent
when there are future cases of abuse.

"The
Department of Health needs to take these accusations and investigations
more seriously," she said. "It's my understanding that Mr. Kpingbah was
a suspect in prior investigations before he was caught raping my
mother, and my mother lived there for 12 years."

Regarding
Sonja Fischer's case, the Minnesota Department of Health found that the
facility acted immediately to ensure the resident's safety and promptly
removed Kpingbah. The state also noted that the facility had provided
Kpingbah with required abuse training. As a result, the facility was not
cited for any wrongdoing; only Kpingbah was held accountable for the
assault.

Maya Fischer had no way of knowing about
the previous allegations against Kpingbah uncovered by CNN. But she
sued Kpingbah, who agreed to an unusual arrangement in which, as of
2017, he is on the hook for a $15 million judgment only if he abuses
again.

Walker Methodist refused to
comment on the previous allegations against Kpingbah, who worked at the
facility for nearly eight years, but said in a statement that it fully
cooperated with authorities and that "the care and well-being of all of
our residents and patients is our primary focus."

Mark Kosieradzki, a Minnesota attorney
who has represented a number of victims and their families, including
the Fischer family, said he has seen the number of nursing home abuse
cases rise within his own practice.

"The
number of calls we get are increasing. The severity of some of the
problems we're seeing is increasing. Whether more people are calling
because there's a greater awareness in the community or whether there's
more problems, I guess it would be nice if we had information from [the
Centers for Medicare and Medicaid Services] about that, but the fact of
the matter is, we'll get six to eight calls a day in our law firm,"
Kosieradzki said.

"Certainly,
there's good nursing homes out there, but there's also nursing homes
that are focused on their profits as opposed to the care they're giving,
and that's what we try to focus on to change," he said.

Although laws require abuses to be
reported and investigated, these laws may not always be followed by some
nursing homes. Then there are concerns that if an incident gets
reported, some experts say, investigationsshouldbe conducted more aggressively.

Many
nursing home employees promptly report abusers to authorities, as
required by federal law, and assist in the investigations, but in
numerous examples of abuse uncovered by CNN in 2017, some facilities
made it possible for violent rapes and sexual assaults to go unchecked.

In
those facilities, allegations were routinely questioned or dismissed
because victims had cognitive conditions such as Alzheimer's. Workers
often lacked the specific training needed to spot sexual abuse, keeping
reports of abuse from ever reaching authorities, and the reputation and
safety of the facility may have taken priority if there was fear that
bringing investigators into a cash-strapped facility could expose other
issues or threaten a nursing home with closure or costly lawsuits.

As
for Wednesday's hearing, Kosieradzki said he hopes for more awareness
about various types of abuse: sexual abuse, overmedicating with opioids
and neglect.

"I'm looking for the
CMS and the [state] Department of Health to start looking at these
consumers and these patients to help them."

Despite
the litany of abuses detailed in government reports, there is no
comprehensive national data on how many cases of sexual abuse have been
reported in facilities housing the elderly.

In
CNN's 2017 analysis, the health departments and other agencies that
oversee long-term care facilities in all 50 states were surveyed. Of the
states that could provide at least some data, the responses varied
widely.

"We
try to identify broader trends about quality of care, but specifically
identifying abuse and neglect can be challenging," Stevenson said,
adding that progress has been made recently.

"Broadly
speaking, I think there have been a lot of quality improvements in
nursing home care over the last few decades," he said. "But I also think
that data have shown that also poor-quality care has been kind of
frustratingly persistent and has been around for a long time."

Stevenson added that he hopes Wednesday's hearing called attention to the issue.

"Hearing
from the relatives of people who have suffered abuse and neglect in
nursing homes will be incredibly important and powerful, and also
hearing from industry leaders and researchers and those who are engaged
in nursing home oversight and accountability I think will be really
important," said Stevenson, who was not involved in the hearing.

"The
big challenge of abuse and neglect in nursing homes is, I think, it has
been persistent over a number of years," he said. "I don't think it's
incredibly prevalent, but really having any abuse and neglect in nursing
homes is not acceptable."

1 comment:

Anonymous
said...

There is no chance against nursing homes tied in to the community with what are supposed to be "charitable" local organizations with long tentacles into every layer of the community and agencies having to do with health care , the bar association members,employees at CMS,the State Dept of Health, etc etc . The tentacles of the shareholders of the nursing facilities are much too long, wealthy and powerful.They do what they need to do to cover . There is too much money and power for them to lose. And we, the loving people just lose the lives of our mothers.

Follow NASGA's Facebook Page

Twitter Updates

Twitter Updates

Follow NASGA on Linked-in

Help Support NASGA!

Another great way to donate to NASGA is by doing your online shopping with Goodshop!
They will donate up to 20% of your purchases back to us and offer great savings at places like Neiman Marcus, Adidas, and Sundance Catalog.
So, you can save money and help us stop guardian abuse too!

Follow by Email

NASGA supports

Disclaimer

Victim stories are written and submitted by individual victims. NASGA has no knowledge or responsibility as to the accuracy or validity of their statements. Use of any such story or information contained therein in any manner is not authorized without prior written consent from NASGA or the individual author.

Comments on this site are moderated. NASGA reserves the right to accept, reject or delete any comments posted. Comments are the sole responsibility of the sender.

This site contains links to web sites controlled or offered by third parties (non-affiliates of NASGA).

NASGA hereby disclaims liability for any information, material, products, services, or any other, posted or offered at any of the third-party sites. By creating a link to a third-party site, NASGA does not endorse or recommend any products or services offered. NASGA further disclaims liability for the content, security, validity or accuracy contained in said third-party sites.

NASGA Followers

NASGA

NASGA (National Association to STOP Guardian Abuse, Inc.) is a 501(c)(3) public-interest, civil rights organization formed by victims of unlawful and abusive guardianships and conservatorships. We seek legislative reform of existing law and upgrading of criminal penalties for court-appointed fiduciaries misusing protective proceedings for unjust enrichment and engaging in elder and family abuse.

Our mission is to promote the safety and well being of adults subject to injury and damage in their person and property through unlawful and abusive guardianship and/or conservatorship proceedings; to end the growing violations of due process, civil and human rights; to work towards ultimate legislative reform of guardianship as presently practiced; upgrading of criminal penalties for court-appointed fiduciaries misusing protective proceedings for unjust enrichment; and to be a support organization for victims and their families. We carry out our mission through research, outreach, education and advocacy; and going forward, by alliance with community interest, law reform, civil rights and other advocacy organizations.

Any copyrighted material included herein is distributed in accordance with the Fair Use section of 17 U.S.C. 107, in the interest of public research and education, without profit.

NASGA claims no credit for any images posted on this site. If there is an image appearing on this blog that belongs to you and you do not wish for it to appear here, please E-mail at Info@StopGuardianAbuse.org with a link to the image and we will promptly remove it.

Comments and opinions posted to our Blog are our readers - not NASGA. We do not censor comments, and we welcome opposing views. We do reserve the right, however, to delete any submitted comment which contains foul or obscene language.

Please visit our website by clicking the link below for more information on how you can help stop guardianship / conservatorship abuse.